Homestead_Womack H. PREPARER
Preparer of the Sales Disclosure Form Title
Jamie E. Smith Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on c4 n ument
Jason Graber
Address(number and street) Address(number and street)
3 Sugarland Estates /U
City,State,and ZIP Code City,State,and ZIP Code N
Washington, IN 47501 U' ?0 ,,e)
Country Country (/,e ?4
Sp
E-mail Address _
my knowledge and belief,is true,cGt5, t and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature o Seller I Signature of Seller
Pri ed Name of Seller Date Signed(mm/dd/yyyy) Punted Name of Seller Date Signed(mm/dd/yyyy)
Jason Graber May 23, 2024 May 23, 2024
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Justin R.Womack Breanna J. Womack
Address(number and street) Address(number and street)
534 N Madison Street _ '534 N Madison Street
City,State,and ZIP Code City,State,and ZIP Code
Oakland City, IN 47660-1205 Oakland City, IN 47660-1205
Country Country
E-mail Address
YES NO CONDITION YES NO CONDITION
❑ 1.Will this property be the buyer's primary 3.Homestead
r sidence? 0 ' 4.Solar Energy Heating or Cooling System
El 2. Does the buyer have a homestead to be vacated 0 [ 5.Wind Power Device
for this residence? If yes,provide address: ❑ 6.Hydroelectric Power Device
Address(number and street) 0 E 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
2.6- ICI - IS -- tOLI-000 . 1 1 -001-- .
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete
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